My breast surgeon breezes out of the consult room and calls another patient in. Through all the heads in the waiting room she finds me and waves, and there is even a smile. She is obviously glad to see me again. You can call me delusional but I speak the truth. This is my second visit to her in the last 2 weeks after my second mastectomy and immediate recon with tissue expander. It’s breast inspection day and there will even be a saline fill from my bearded plastic surgeon after our consult.
In the 8 seconds she appears outside the consult door with patient file in hand, I drink in as many details as I can. Her hair is lightly tussled. She is dressed in a black tailored jacket with a very short cream frill layered skirt with black sash trim. There are those impressively elegant legs that are finished off with canary yellow stilettos with silver toe plate detail. Spring is here. Gone are the black tights and designer boots of winter. Simultaneously, the track below begins to play in my head like we are in a movie scene. Press play, go on, do it now. Okay, you can pause that at any time.
After a short wait I am called. As I walk through the door I nervously blurt out how fabulous she looks. I am greeted and inspected with the usual efficiency. The operated breast looks good just 16 days post surgery. She snips a stitch that hasn’t broken down. She has taken the cancer, 22 lymph nodes and 2 breasts. Her job is mostly done with the exception of a visit in 6 months and then annual reviews for the next 5 years. Simple.
Next my bearded plastic surgeon enters the room wearing a hospital fundraising, cancer charity, cycling jersey over his usual business attire. As he steps towards me his mobile phone rings with the opening chords of a “bad to the bone” ringtone. Mr Cool and I break out in laughter. He inspects his handy work looking at both tissue expanders that have been inserted six months apart. They are considerably different in size but he isn’t worried.
The exchange surgery next year may include using 2 different sized silicone implants to get visual symmetry. He is happy that the nipple looks like it will survive, making the same comment as the breast surgeon minutes prior. I hadn’t even given that a thought this time. As it blackened from the trauma of the mastectomy and was at risk of infection I just assumed it would be safe like the last time. Then he asks me if I would like a fill inserted into the new tissue expander which is noticeably smaller than the one done back in February. I nervously giggle and nod for I am about to get ‘a bigger one’.
He leaves the room and returns with a 1 litre bag of saline and an enormous syringe and needle. He asks me to lay down on the hospital bed bare chested. He uses the magnetic port finder to locate the port, marks a spot with purple texta on my chest which is still tender from last fortnight’s mastectomy and recon surgery. He then inserts the enormous needle on saline into my breast, piercing through the skin into the port. I don’t feel a thing and he proceeds to fill the expander. First 20, 40 and then 60mls and I begin to feel tightening and constriction in the pectoral muscle across my chest and just under my armpit. I wonder if I can breathe. So I take some breaths to test the vice grip that is tightening around my rib cage.
He says “Make sure you tell me when you are uncomfortable. I don’t want you to be a hero.” I nod conservatively. The sensation of filling fools me into thinking it is possible my chin might just hit my breast when I nod. Lying on the hospital bed I’m not sure what I can tolerate so I laugh. He keeps filling to 80 mls, and I exhale and say… “Yes, yes I think that is enough for now!”
As the pressure mounts it’s like a tightening in the pectoral muscle accompanied with knife pain extending round under my armpit into my back. Very, very painful. He backs off and takes out 10mls and there is instant relief. The volume of two teaspoons. Together we then decide to take out another 10mls which is more tolerable. When he withdraws the needle it feels like I am a rubber mannequin. The body isn’t mine. The needle catches and as it withdraws the expander holds onto the needle tightly, vibrating and pulling.
He has inserted just 60mls in total, the equivalent of 2 shot glasses or 3 tablespoons, depending on if you are a bartender or a baker. I think of those women who have fill after fill of half a litre in each expander and greater. And those women who go through this process for cosmetic reasons. Cancer brought me to this point so I feel a little differently. I am left with 144mls in my first expander from February and today I lay with 280mls in my right expander. Interestingly, the February breast is much bigger. He assures me the mathematics is not important. The final exchange will work out the symmetry.
After the procedure, I need help getting up off the bed and look at my chest in the mirror. The breasts now look quite even. Mr Cool helps me with dressing as my arm and chest are not sure how or if they should be moved. We very slowly walk out of the hospital as I experiment with new strategies for breathing. We dawdle to one of our favourite city lunch spots. On the way Mr Cool and I debate about who my plastic surgeon was speaking to when he answered his bad to the bone ringing mobile. I envisaged him talking to his daughter about his grandchild going to sleep. Mr Cool felt it was a patient going to sleep in surgery. It doesn’t matter who is right. We are hungry and I don’t know if I can even lift or move in particular ways or even eat with the sensation of just 60mls. I wonder how on earth I will make the 150km journey of bumpy roads home? For now, the breathing, is okay though. And I intend to return post radiotherapy for another very small fill in late October.
There has been 2 and a half weeks of post surgical pain and recovery. There has been a very conscious attempt not to get addicted to serious pain analgesics. There has been careful management of an Exudrain surgical drain which I am now free from. There have been daily nurse visits to my home, and persistent post chemo and surgical drug induced digestive woes. I have been fortunate enough to have had some wonderful visitors in my home including my mother and sister in law. They are now gone and life is moving forward.
Very soon I will post the retrospective blogs I wrote in the last three weeks. While high on Endone and OxyContin and suffering the after effects of five months of chemo, surgery and the dizziness of low haemoglobin, I lost my blog voice and could not concentrate for any length of time. But I am back with a clear mind. So stay tuned.